"Sorry for being me, I don't know how to be anyone else" - Spike Milligan

Monday, 1 March 2010

Go treat yourself

Every so often some bright spark suggests that the NHS shouldn't treat people with "self-inflicted" ailments. Things like alcoholism, drug addiction, obesity, anorexia.

It sounds good on paper, for about five minutes. It would save the NHS millions of pounds, we would all pay less tax, and it would encourage people to take more care of their health.

But in reality the idea just doesn't stack up. For a start, how do you decide that something is self-inflicted? If someone is overweight, they may be over-eating or they might have faulty genes or a hormone imbalance. They might say they've genuinely tried to lose weight but nothing has worked.

If you refuse to treat a "self-inflicted" illness it could get worse, meaning far more expense farther down the line as the illness becomes terminal or the person loses their job or becomes a burden on others.

Also, any ailment can be seen as self-inflicted if you so choose. The hill-walker who breaks a leg on a mountain-top. The gym enthusiast who has a heart attack during a workout. The rock musician with hearing loss. If they hadn't been doing those things in the first place, they would be fine....

And who exactly would make the fateful decision? A doctor? A petty official? Your right to medical treatment would be subject either to someone's personal whim or some baffling set of guidelines. You sometimes use the lift and not the stairs? Sorry, mate, we can't help you.

Not to mention the awful choice for someone who's hard-up whether to scrape the money together for private treatment or somehow live with the illness.

In the end, it's just an attempt to blame the victim for their problem instead of giving them what they need. Of course we all try to avoid getting ill. Nobody wants to be swallowing a load of medicines or languishing in a hospital ward. But despite our best efforts, we can still succumb to ill health and it's up to the NHS to help us.

14 comments:

yes, that idea gets tossed around here at times and my reponse is always the same. exactly where should the line be drawn?its just the tip of a user pays iceberg and the people who say these things have obviously never been really sick

Kylie - Precisely, where do you draw the line? It sounds simple but as soon as you start thinking about it, it's impossible to define. And you're right, these idiots can't ever have been seriously ill.

We have a similar health system here as you know and yet we all finance it whether our illness is self inflicted or not. I pay private health insurance and a Medicare levy even though I don't uses the public system except for the very rare doctor's visit and have spent 3 stints in hospital (all covered by my private insurance and two of those for the birth of my children) over the past 53 years! I think I've paid for my 'indulgences' even if they do make me ill one day! Do we stop treating drug addicts? Homeless drunks and psychotics . . I think not.

Baino - You certainly have paid for your indulgences, you deserve proper care if they ever catch up with you! Of course we all pay for the NHS as well, but are we ever consulted about radical changes in the way it's run? Of course not. Apart from election manifestos, that is.

Very interesting, and oddly paternalistic in reverse, if you know what I mean...

I mean it's still sort of parental: "you made your bed, now lie in it!!!" Like a punishment for "bad" behavior. Disturbing indeed.

By the way, I've enjoyed catching up a little here. I've gotten so used to reading every post of yours when they're posted, it felt strange to miss out! Man, I'm out of the loop. You have no idea. I'm telling you, Nick, this has been one crappy winter here at our house...(whinge, whinge, I know, I can't help it...)

It is a dangerous precedent, and not just for medical treatment. I mean if you draw the line at not treating people who are sick because they allegedly made themselves sick, why would you give food and shelter to homeless people who made themselves homeless? Justice to a beating victim who willingly went back to an abusive spouse?

It's not them, about why someone needs help. It's about us, and why we show compassion. Because we're human, and that's what humans do.

Nick, in India we do not anything remotely like the NHS. The poor have access to Government hospitals which they use quite freely at minimal cost. The middle classes and the better offs have to fend for themselves and some take health insurance which factors in various qualifications but by and large works. Most however depend on the family's support for good medical treatment. I now personally have a problem in looking after my father and another very serious case of a boy withbipolar disorder with alcohol abuse, who is undergoing the most expensive treatment and the family are selling their family jewels to finance the treatment. Families do not have the luxury of drawing any lines however fine that may be.

Ramana - I'm sorry to hear of your difficulties over medical problems. It's absurd that families should have to bear the cost of what can be very expensive treatments, instead of the cost falling on the whole society. We sometimes forget that for all its faults the NHS is still a remarkably egalitarian and democratic service.

About Me

I've known my partner Jenny for over 36 years. Currently working for a voluntary organisation, I was previously a journalist, bookseller and charity worker. I enjoy the company of my partner and friends but I'm not a wild socialiser. I love walking in the country and just quietly reflecting on life. Disillusioned with living in London, Jenny and I moved to Belfast in 2000. We're still in Belfast and we think it's a fabulous city.